Diagnostic value of lymph node fine needle aspiration cytology: an institutional experience of 387 cases observed over a 5-year period

Lymph node fine needle aspiration (LNFNA) cytology is valuable in solving t he diagnostic problems of clinical adenopathy. The usefulness of the proced ure in the staging and diagnosis of various malignant and lymphoproliferati ve tumours, as well as its role in distinguishing reactive hyperplastic lym ph nodes from lymphoma, has been documented in the literature generally on an individual basis(1-12) We report our cumulative 5 year experience of LNF NA representing 387 cases. Approximately half(n = 182) were diagnosed as ei ther metastatic carcinoma or melanoma; in 54 cases (30%) excisional biopsy or tissue study was performed to confirm the diagnosis; there was only one false-positive diagnosis of a metastatic squamous carcinoma rendered on a s ubmandibular lymph node. Sixty-one lymphoma cases were successfully diagnos ed via LNFNA with no false positives; concurrent flow cytometry was utilize d in 51% (n = 31) of the 61 cases and supported the cytologic diagnosis of lymphoma in 27 of the 31 cases (87%). A benign or reactive lymph node proce ss was also diagnosed via LNFNA alone or in combination with flow cytometry in 48 cases with only five false negatives, which included four cases of m antle cell lymphoma and one case of melanoma. Unsatisfactory cases accounte d for 12%, and represented specimens obtained by 'Wang needle' or other eme rging techniques. Our study demonstrates that LNFNA can be an accurate, eco nomical and rapid diagnostic procedure.